Are we about to move towards keyboardless hospital information systems (HIS) in the years to come? Speech recognition systems for English speaking health care professionals are already conquering the markets. The Dutch company, MDT Information Division BV, has now designed the first speech recognition software package for Dutch medical terminology. Other versions are being prepared for Germany, Belgium, and France. Italy and Spain soon will follow. MDT is working together with native speakers who are familiar with the vocabulary of the various medical specialities in the different countries. The Clinical Reporter system has been developed for use in orthopaedics, surgery, radiology and gynaecology. Managing Director, Dion Janssen, has set his mind on teaching European doctors to talk with the computer.
MDT Information Division BV constitutes a fast growing part of the Medical Development & Technology (MDT) Group, that is headquartered in Brabant since 1985. Initially, MDT was a manufacturer of medical equipment but ten years ago, started a special division for speech recognition applications, under the tradename of VoiceMagic. The founding partners, Frédérique Juten and Dion Janssen, have introduced two other shareholders in order to spread the financial risk. Both the local industrial development society and PARNIB Converging Technologies, a part of the PARNIB Holding NV, which in turn is a subsidiary of the Dutch National Investment Bank, each for a substantial percentage participate in MDT. The company also investigates opportunities for a separate research department in Flanders Language Valley, referred to as the Belgian Silicon Valley for informatics and linguistics, and which is situated near the Flemish town of Ieper.
The English medical speech recognition system Voice Xpress for Medicine, developed by the Flemish global market leader Lernout & Hauspie, is not very suitable for the Dutch health care sector, according to MDT Manager Janssen, for both sociological and linguistic reasons. For instance, the phonetic combination "ch", which is typical for Dutch and German, is wrongly interpreted as a blurred sound by the English system. The MDT Clinical Reporter consists of a CD Rom and a headset. The accuracy of performance amounts to 97%, provided that the system based on self-tuition is frequently used. The secret of an effective speech recognition package constitutes a well established database, set up by a team of computer specialists, linguists and competent medical specialists.
An internist in a university hospital uses a professional vocabulary of 30.000 specialized terms, whereas a physician, working at a regional clinic, only needs 17.000 different items. The Clinical Reporter system is able to "understand" most of the words, although the user is allowed to introduce new vocabulary. After years of experience, MDT is now able to develop a speech recognition system for a new professional category, such as juridical counselling, insurance activities or accountancy, in about three months time. Thousands of written documents have to be scanned to select the specific vocabulary and afterwards, the system's efficiency has to be checked by people, who are active in the targeted profession. The major problem consists in interconnecting the various databases, such as those of the medical specialists with the ones, located in the HIS, and the hospital laboratory, for example.
In any case, medical specialists henceforth can dictate patient letters of discharge and have them printed out by the computer without any mistakes. The physician immediately controls the output and can correct wherever necessary. The letter is sent to the patient's general practitioner on the same day as well as to the HIS for archival, which is the dream of every hospital manager. Out of the 150 Dutch hospitals, 60 are already using the Clinical Reporter in some way or another. In one of the clinics, the computer is situated next to the operating theatre. After the surgical intervention, the physician is able to immediately dictate further treatment and medication instructions for print-out. The document accompanies the patient to the specific department.
The Clinical Reporter equally pays large services to the pharmaceutical industry. In five hospitals, the Dutch company BYK NV has installed the Pantoscope, a speech recognition system for gastro-enterologists, who frequently write prescriptions for specialized medication. Speech recognition technology doesn't require any computer knowledge from the user. As such, it constitutes an ideal tool for older medical specialists, who are not that familiar with information technology. Because of the Clinical Reporter's success, MDT has doubled the number of personnel from ten to twenty and still continues to expand. We have used de Volkskrant as our major source for data on MDT. For more general background information, we refer to our article on speech recognition in this very same VMW issue.